Provider Demographics
NPI:1710902325
Name:PIKA, DANIEL L (PAC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:PIKA
Suffix:
Gender:M
Credentials:PAC
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Other - Credentials:
Mailing Address - Street 1:2970 DEDE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048-2340
Mailing Address - Country:US
Mailing Address - Phone:410-861-8960
Mailing Address - Fax:
Practice Address - Street 1:444 WMC DR STE 100
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21158-4337
Practice Address - Country:US
Practice Address - Phone:410-751-2595
Practice Address - Fax:410-751-2593
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD1028016363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD232305YBDBMedicare PIN